National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

This is VAERS ID 1405009



Case Details

VAERS ID: 1405009 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Chills, Fatigue, Headache, Hyperpyrexia, Injection site erythema, Injection site inflammation, Injection site pain, Injection site swelling, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Body temperature; Result Unstructured Data: Fever 40.5 to 42 degrees Celsius
CDC Split Type: NLJNJFOC20210623131

Write-up: FEVER 40.5 TO 42 DEGREES CELSIUS; COLD CHILLS; FATIGUE; HEADACHE; REACTION AT OR AROUND THE INJECTION SITE REDNESS; REACTION AT OR AROUND THE INJECTION SITE PAIN; MUSCLE PAIN; REACTION AT OR AROUND THE INJECTION SITE SWELLING, ONSET WITHIN ONE WEEK OF THE VACCINATION; INFLAMMATION REACTION AT THE REACTION (INJECTION) SITE REDNESS, PAIN, SWELLING, ONSET WITHIN ONE WEEK AFTER THE VACCINATION; FEELING UNWELL; JOINT PAIN; This spontaneous report received from a consumer via a Regulatory Authority [EMEA EVHUMAN NLP, NL-LRB-00566515] concerned a 22 year old male with unknown ethnicity and race. The patient''s weight was 72 kilograms, and height was 190 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 21C10-02 expiry: UNKNOWN) dose was not reported, 1 total administered on 01-JUN-2021 for covid-19 immunisation. Drug start period was 6 (Hours). No concomitant medications were reported. On 01-JUN-2021, the patient experienced inflammation reaction at the reaction (injection) site redness, pain, swelling, onset within one week after the vaccination, feeling unwell, joint pain, reaction at or around the injection site redness, reaction at or around the injection site pain, muscle pain, reaction at or around the injection site swelling, onset within one week of the vaccination, headache. On 02-JUN-2021, the patient experienced fever 40.5 to 42 degrees celsius, cold chills, fatigue. Laboratory data included: Body temperature (NR: not provided) Fever 40.5 to 42 degrees Celsius. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever 40.5 to 42 degrees celsius, and cold chills on 02-JUN-2021, and feeling unwell on 03-JUN-2021, was recovering from reaction at or around the injection site redness, reaction at or around the injection site pain, reaction at or around the injection site swelling, onset within one week of the vaccination, inflammation reaction at the reaction (injection) site redness, pain, swelling, onset within one week after the vaccination, fatigue, and headache, and had not recovered from muscle pain, and joint pain. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210623131-COVID-19 vaccine ad26.cov2.s - FEVER 40.5 TO 42 DEGREE CELSIUS. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s)


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1405009


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166